Surgery and fertility

Removing a testicle (orchidectomy)

Most men have cancer in one testicle and it is removed to treat their cancer. For most of these men it won’t affect their ability to have children. But for some men their remaining testicle might not work so well and this could reduce their fertility.

Some men have cancer in both testicles and both are removed to treat their cancer. These men are infertile and won't be able to father children.

Removing lymph nodes (retroperitoneal lymph node dissection

Very rarely, the lymph glands in your tummy (abdomen) might need to be removed by surgery to treat non seminoma cancer. This surgery can make you ejaculate backwards (retrograde ejaculation). Your semen and sperm go back into your bladder instead of coming out of your penis.

If you have retrograde ejaculation you won't be able to have children by natural sexual intercourse. But it may be possible to take sperm directly from your testicles or from your urine after you have had sex. The sperm can be used to fertilise your partner directly or with in vitro fertilization (IVF).

Chemotherapy and fertility

Chemotherapy for testicular cancer causes temporary infertility in most men who have it.

Usually fertility goes back to normal some months after the chemotherapy ends but for some men it doesn't recover. This is most likely if you have had very high doses of chemotherapy.

Radiotherapy and fertility

Your doctors will advise you not to try to father a child when having radiotherapy treatment, and for up to a year afterwards.

When treating the lymph nodes in the abdomen, the radiotherapy beams are directed at an area down the middle of the stomach or abdomen, and sometimes at the groin. There is a small risk of the remaining testicle receiving a dose of radiation, as it is quite close by. The testicles are where sperm are made. Your radiographer uses a lead shield to protect the testicle from the radiotherapy beams but there is still a small chance of damage.

In a healthy testicle, sperm are constantly being made, so any effects from the radiotherapy should usually only last for a few months after treatment ends.

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